Abstract
Background: School-based professionals play a crucial role in supporting autistic learners, with teachers and occupational therapists being primary implementers of education and health policies. The support context reflects cultural feminist principles, as women professionals predominantly provide immediate support in schools.
Aim: This study aimed to explore experiences of women professionals in supporting autistic learners within feminised special education contexts, utilising neurodiversity theory and feminist institutional theory as the conceptual framework.
Setting: The study was conducted at the Centre for Neurodiversity, utilising a purposive sampling approach across four special schools in Johannesburg Central district. The participant sample comprised 3 teachers, 2 occupational therapists, 1 assistant teacher, and 17 parents.
Methods: A qualitative interpretive methodology allowed participants to share their daily experiences in caring for and supporting autistic children. Focus group discussions were used as a data collection technique. Data were analysed using thematic analysis. Ethical considerations were highly prioritised.
Results: Cultural feminism ideology has been applied by default in supporting learners with neurodevelopmental conditions in special schools. Women in professional spaces are responsible for immediate caring and supporting autistic learners. The role played by men is invisible in these social spaces. This has led to the feminisation of special educational contexts.
Conclusion: This study contributes to understanding how the feminisation of educational support roles impacts both service delivery and professional well-being, emphasising the need for gender-responsive policies and enhanced support systems in special education contexts.
Contribution: This study expands knowledge concerning gender imbalances in supporting autistic learners in educational settings.
Keywords: autism; feminism; neurodiversity; special education; support.
Introduction
School-based professionals play a crucial role in supporting autistic learners, with teachers and occupational therapists (OTs) being primary implementers of education and health policies. This article examines findings from an April 2024 discussion at the Centre for Neurodiversity, which gathered insights from women professionals and caregivers about their experiences supporting autistic learners. The discussion revealed that women constitute most immediate support providers both at home and in school settings, highlighting the feminisation of autism support contexts. This article explores professionals’ experiences supporting autistic learners within these feminised education contexts, examining the implications of gender composition in support roles. The discussion begins by conceptualising autism in the South African context, followed by an analysis of educational support systems and the roles of teachers and OTs in special schools. The article examines the advantages and challenges of supporting learners in feminised education contexts, presents the study’s conceptual framework and methodology, and concludes with findings on professionals’experiences.
Conceptualising autism in South African context
Autism is a neurodevelopmental condition identified by various characteristics that usually include difficulty in social communication or having a restricted set of behaviours. Individuals diagnosed with autism face challenges in learning and development because their impairments range from high functioning to low functioning, requiring more intensive support and other care interventions (Pottas & Pedro 2016). Giroux and Pélissier-Simard (2021) explain that there are three important neurocognitive characteristics related to autism: mind blindness, weak central coherence and executive dysfunction. Ouhtit et al. (2015) also describe the other characteristics such as oversensitivity to sight, hearing, smell, touch or taste. Such individuals perform repeated body movements and tend to have a limited attention span. They react to loud noises but find normal noise painful and can be aggressive to themselves as well as others. They have difficulties in maintaining a conversation and communicate mostly using actions or gestures (Ouhtit et al. 2015). This could be because most of them have language impairment or may not develop spoken language at all (Wolf, Barton & Jou 2018). They prefer solitary play and show a lack of empathy (Ouhtit et al. 2015). Macha, Simui and Muzata (2020) purport that within a classroom environment, naturally being an interactive social environment, the characteristics of children with autism can be problematic to learning conditions. Difficulties in social communication promote misunderstandings escalating into deviant behaviours. Teachers most likely struggle with classroom management (Macha et al. 2020).
There is limited information on the prevalence and support of neurodevelopmental conditions such as autism, especially in African contexts (Hadder-Algra 2021). In South Africa, national statistics and knowledge on the prevalence and incidence of autism are generally unclear, as the statistics are unavailable (Mofokeng et al. 2023). However, efforts are being made to raise awareness and support for children with neurodevelopmental conditions such as autism in selected areas in the country (Mazibuko, Shilubane & Manganye 2020). For instance, organisations and support groups, such as the Centre for Autism Research in Cape Town and Autism South Africa (ASA) (Adams 2024), have improved early screening and assessment services. The establishment of the Centre for Autism in Cape Town contributes to research initiatives in Africa and beyond (Aderinto, Olatunji & Oluwatobi 2023). Other support groups such as Mothers of Children with Autism (MOCWA) and Fathers of Children with Autism (FOCWA) have raised awareness and provided identification and support services to children with autism (Adams 2024).
Similarly, at the forefront of raising awareness, identification and support of children with neurodevelopmental conditions is the Centre for Neurodiversity at the University of Johannesburg. The Centre is a collaborative effort between the University, the Department of Educational Psychology and various stakeholders, to advance knowledge, skills and support for individuals with neurodevelopmental conditions. The Centre focuses on training stakeholders in the field of education on neurodiversity, facilitating interprofessional and parental collaboration on the support of learners with neurodevelopmental needs, and offering scholarships such as the Mpedi family scholarship for neurodiversity studies, thereby promoting research and understanding in the field.
Supporting autistic learners in feminised education contexts
The education system in South Africa acknowledges that learners are different and that some have challenging conditions that may impact their learning and competency. There are three types of schools as described by the Education White Paper 6 [EWP6] (Macha et al. 2020). Mainstream schools are the first level of three types. They are intended to cater to a diversity of learners in the classroom, including those with low and moderate support needs. The second type of schools are full-service schools (Macha et al. 2020), which are equipped with additional human and material resources to cater to the needs of learners with neurodevelopmental conditions such as autism, learners with physical challenges and typically developing learners. Special schools are the third level of school placement in the education of learners in need of a high level of support that cannot be accommodated in mainstream or full-service schools. Such schools provide special professional support in curriculum, assessment, and instruction and developing learner’s strengths and competencies (Adewumi, Mosito & Agosto 2019).
Despite South Africa’s inclusive education policy (Department of Education [DoE] 2001) advocating for mainstream school placement, many autistic learners attend special schools based on their support needs. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines three support levels for autistic learners. Level 3 learners require very substantial support because of severe deficits in verbal and nonverbal communication, along with significant difficulties coping with change (Erasmus, Kritzinger & Van Der Linde 2019). Such learners are accommodated in special schools (Nthibeli, Griffiths & Bekker 2022). Level 2 learners need considerable support to address marked communication deficits and restricted behaviours that impact their functioning across contexts. Level 1 learners require minimal support and can typically participate in mainstream education (Macha et al. 2020). Special schools primarily serve learners at Levels 2 and 3, whose functional abilities and behavioural differences necessitate specialised support beyond what mainstream settings can provide (Erasmus et al. 2019).
Feminism refers to social movements and ideologies aimed at achieving gender equality and eliminating societal inequities based on gender, derived from the Latin word for ‘women’ (Raina 2017). Feminism can be manifested in the following categories: liberal, Marxist, socialist, radical, ecofeminism, black, cultural and post-modernism feminism (Mohajan 2022). This article focuses on cultural feminism, which philosophises that males and females have different attitudes to the world around them and that greater value should be applied to the way females approach the world (Mohajan 2022). Cultural feminism emphasises traditionally feminine qualities such as cooperation, relationships, care, and empathy as valuable approaches to the world. This perspective recognises distinctive virtues in women’s character, often termed the ‘ethic of care’.
The support of autistic learners in education contexts reflects cultural feminist principles, as women professionals predominantly provide immediate support in schools. This feminisation of education contexts – defined as the predominance of female professionals in educational care and support roles – is particularly evident in special education. Ingersoll et al. (2021) contend that the prevalence of women in school-based professions aligns with traditional gender roles, where women are perceived as naturally suited to child-rearing and caregiving. This aligns with the broader trend of women entering female-dominated fields. A significant factor contributing to this high female representation is the perceived compatibility between nurturing and child-rearing roles (Ingersoll et al. 2021). The following sections examine the roles of teachers and OTs in learner support, analysing the implications of this gender-based professional composition.
The role played by teachers in the classroom is invaluable. Teachers are the primary resource for achieving the educational goals of an inclusive education and training system. They are the implementers of educational policies. They are required to develop Individual Education Plans (IEPs) to collect data on their learners, interpret legislation and manage the medical needs of the learners (Ryan & Mathews 2022). There are also teaching assistants (TAs) who assist the teachers with classroom activities and management.
The dominant presence of females in teaching, particularly at the primary school level, has raised concerns about the ‘feminisation’ of teaching (Acker 1995:100). In South African contexts, there are more female teachers across primary and high schools (Schmude & Jackisch 2019). There has been a discussion about the negative consequences of feminisation for boys. The feminisation of teaching was seen not only as a cause for boys’ problems in schools but also as a contributing factor for other educational problems and social crises, such as boys’ failure to sufficiently develop male identity (Schmude & Jackisch 2019).
In countries with a long tradition of female teachers such as the United States of America and Great Britain, research and debates have emerged on the effects of feminisation in the teaching profession. According to Schmude and Jackisch (2019):
At the end of the 1970s, the debates about feminisation processes reached a new climax initiated by the publication of ‘Mother teacher’ … whose author held feminisation responsible for failure of the USA’s education system. Critics claimed that children’s intellectual development suffered from anti-intellectual, feminine pedagogy which concentrated on children’s social, creative, emotional, and moral skills. In literature, this feminine pedagogy became synonymous with soft pedagogy. ‘Soft’ pedagogy is contracted to ‘hard’ pedagogy which is geared towards the desired levels of learning outcomes (p. 343).
In the South African context, Davids and Waghid (2020) also purport that the feminisation of teaching influences the primary pedagogy and culture. Such problems involve daily routines and practices that favour females, female teachers holding low expectations of boys’ abilities, and the absence of male role models, which creates problems for boys in terms of motivation, discipline and social interaction. In the same vein, Schmude and Jackisch (2019) also highlight the effects of lacking male role models, which may affect the academic achievement and social behaviour of the boys.
Literature on the nature and characteristics of autism explains that autistic learners have difficulties interacting with others and face both verbal and nonverbal communication challenges (Giroux & Pelissier-Simard 2021; Ouhtit et al. 2014). This makes the classroom setting difficult for them, and it makes teachers struggle with behaviour management (Nthibeli et al. 2022). Macha et al. (2020) also argue that teachers are most likely to struggle with classroom management because of the characteristics of autistic learners. A research study by Numisi et al. (2020) in the Limpopo province concluded that teachers felt ill-prepared without adequate skills to assume their roles and were overwhelmed by the needs of autistic learners. This raises concerns about the effectiveness of female teachers in supporting autistic children. This also raises concerns about the psychological impact that they endure when teaching the learners. Ramdan (2020) conducted a study on burnout and related factors among special schoolteachers. The study’s findings revealed that special needs teachers are more vulnerable to burnout compared to teachers in mainstream schools. The study also concluded that most of the teachers in special schools are females.
The challenges faced by female teachers in supporting autistic learners have led to increased recognition of the need for multidisciplinary support in special education settings. This has resulted in a growing presence of school-based female OTs in South Africa, further reinforcing the feminised nature of learner support services. The role of OTs in schools is to support learners whose needs cannot be solely met by their teaching team. Several studies have supported the collaboration between OTs and teachers to improve the outcome of learners with neurodevelopmental needs (Hargreaves et al. 2012).
The OT’s role often adopted in the education framework is one of consultant for parents and teachers. They provide flexible and diverse support to learners with special needs (Salazar Rivera et al. 2023). They provide training and education to teachers on how to modify teaching techniques and access assistive devices to adjust and meet the needs of the learners. Their services enable the facilitation of an environment that meets the learner’s needs (Sonday et al. 2012). Occupational therapists are well equipped to offer support in working with learners with autism because of their understanding of personal, environmental and activity-related requirements that can promote or hinder a learner’s participation in the school environment (Grandisson et al. 2020). Thus, autistic learners are exposed to a dual kind of support in educational settings, education as the transfer of knowledge and education as therapy (Ryan & Mathews 2022).
Globally, occupational therapist (OT) is a female-dominated profession (Ned et al. 2020). According to Mendoza-Holgado, Cantero-Garlito and Barrios-Fernandez (2023), as a result of an increasing number of women in the profession, there has been ‘feminisation’ of the profession. This is supported by the World Federation of Occupational Therapists (WFOT) data provided by 89 member organisations, which represents 633 000 OTs internationally. According to WFOT, 80.30% of OTs are women. There is a social perception that the professions linked to care are exercised by women (Mendoza-Holgado et al. 2023).
Maxim and Rice (2018) carried out a study in the United States examining the reasons behind gender disparities in the profession; 699 OTs, both male and female, were asked questions regarding their satisfaction with their profession despite the gender ratio. Females felt they were beneficial from an emotional standpoint. In South Africa, a study by Ned et al. (2020) sought to describe the demographic trends of OTs registered with the Health Professions Councils of South Africa (HPCSA) from 2002 to 2018. A total of 5180 OTs were registered with HPCSA in January 2018, with females comprising 95%, compared to 5% males. In 2018, the OT workforce was female and classified as white across all age groups. The few males in the profession were mostly younger and categorised as black (Ned et al. 2020).
There is a notable gender disparity in the support of learners with neurodevelopmental conditions such as autism in education settings, with women predominantly occupying school-based professional roles. While traditional perspectives have attributed women’s prevalence in these roles to perceived natural caregiving abilities, this view requires critical examination. Research evidence indicates that school-based professionals, particularly teachers, face significant challenges in supporting autistic learners because of complex behavioural presentations and support needs. Studies investigating teachers’ experiences in special schools consistently report high levels of burnout and psychological strain associated with supporting learners with neurodevelopmental conditions such as autism. In response to these challenges, there has been an increase in school-based OTs to support both teachers and parents. This interdisciplinary approach aims to alleviate pressure on teachers by distributing responsibilities across multiple professional groups. However, this solution has inadvertently reinforced the feminisation of special education contexts, as most OTs are also women. These study findings highlight the need to critically examine both the gendered nature of educational support roles and the systemic supports necessary for all professionals working with autistic learners. This study seeks to explore and critically analyse the experiences of women professionals in supporting autistic learners within feminised special education contexts, using neurodiversity and feminist institutional theory as its conceptual framework.
The conceptual framework integrates the neurodiversity theory and feminist institutional theory to critically examine the experiences of female professionals supporting autistic learners in feminised special education contexts. The concept of neurodiversity was initially introduced in academic circles by Judith Singer, who asserts that the variations in human cognitive processes ought to be regarded as a natural occurrence (Rollnik-Sadowska et al. 2024). The neurodiversity theory represents a theoretical viewpoint regarding the inherent diversity among learners. It posits that variations in cognitive processing are a natural occurrence within the learners and should be regarded as value-neutral (Alcorn et al. 2024). This perspective challenges the notion of a singular standard of a ‘normal’ or ‘healthy’ brain, against which all other cognitive functions are measured. Originally, this term covered only autism, but the current perception is much broader and includes learners with other neurodevelopmental conditions such as ADHD, dyslexia, dyspraxia, dysgraphia, dyscalculia, Tourette’s syndrome and communication disorders (Rollnik-Sadowska et al 2024). The perspective of neurodiversity advocates for the belief that learners with neurodevelopmental conditions ought to be acknowledged and supported rather than sidelined (Nelson 2021). Building upon this neurodiversity theory, feminist institutional theory offers complementary insights into how educational institutions can better support neurodiverse learners. Education settings should not limit the support of learners with neurodevelopmental conditions.
Joan Acker was the first scholar to fully theorise the institutional embeddedness of gender. Much of the previous studies that have utilised this framework have examined highly ‘male’ gendered organisations (Boone Parsons et al. 2012). However, this study is guided by this theory to examine female-gendered education institutions. Acker (1990) argues that processes, practices, images, ideologies and distributions of power within the institutions promote gendered work practices (Clavero & Galligan 2020). Gendering processes can be found in both male- and female-dominated organisations (Boone Parsons et al. 2012). According to Acker (1990), gendering within institutions occurs through several interconnected processes. Firstly, gender divisions are maintained through the institutionalised patterns of jobs, hierarchies, power and subordination. These divisions, while sometimes subtle, reinforce traditional gender roles within the organisation. Secondly, the social construction of symbols such as artefacts and images can justify and reinforce existing gender divisions, often symbolising power dynamics within an organisation (Boone Parsons et al. 2012). Thirdly, interactions between individuals can enact domination and submission, creating alliances and exclusions that further solidify gendered power structures. Fourthly, identity work refers to individuals’ efforts to construct their gendered identities and appropriate behaviours within the organisation to ensure survival, thereby reinforcing the gendered nature of the institution (Boone Parsons et al. 2012). Finally, organisational logic, the underlying assumptions and implicit rules about how organisations should function often embody a ‘gender-neutral’ ideal that obscures and perpetuates gendering practices. This theory clarifies the context-dependent relationships present within institutions and among gendered social actors. It posits that both formal and informal rules, norms and practices dictate what constitutes ‘acceptable’ masculine and feminine behaviours for men and women in institutional settings, thereby generating results that contribute to the reinforcement or reproduction of wider social and political gender expectations (Clavero & Galligan 2020).
This study’s conceptual framework integrates the neurodiversity and feminist institutional theories to examine how female professionals support autistic learners in educational settings. The neurodiversity theory provides the foundation for understanding autism as a natural variation in human cognition rather than a deficit. This perspective emphasises the importance of supporting and accepting autistic learners instead of trying to make them conform to typical standards. Complementing this view, the feminist institutional theory illuminates how gender shapes institutional practices and structures in educational settings. This theory is particularly relevant, as it helps us understand how female-dominated educational environments influence institutional operations, decision-making processes and support systems for learners. The integration of these two theoretical perspectives creates a unique lens for examining how the feminised nature of educational institutions shapes autism support practices, while also revealing how female professionals navigate and sometimes challenge institutional structures to better serve autistic learners. Through this dual theoretical lens, the study can better examine how institutional gender dynamics affect both the professionals providing support and the autistic learners receiving it. This combined theoretical approach is presented in Figure 1.
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FIGURE 1: Conceptual framework-supporting autistic learners in feminised education contexts. |
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Research methods and design
Research paradigm
Research paradigms establish a foundational structure for the research process, directing the methods of data collection, analysis and interpretation. The interpretivist paradigm guides this study, recognising that reality is a subjective construct shaped by individuals through their individual experiences and social interactions (Turin, Raihan & Chowdhury 2024). Interpretivism acknowledges the influence of varying cultures, contexts and temporal factors in shaping distinct social realities (Alharahsheh & Pius 2020). Ontologically, this paradigm assumes the existence of multiple realities, socially constructed by individuals through their lived experiences and interactions. Epistemologically, interpretivism emphasises understanding how individuals experience and interpret their reality (Pervin & Mokhtar 2022). This framework is particularly relevant to this study, as it allows for the exploration of the intricate and diverse viewpoints of school-based professionals supporting autistic learners in special school settings. By adopting an interpretivist lens, the research aims to comprehend the nuanced ways in which these professionals experience their roles and navigate the challenges presented by gendered educational settings, contributing to a deeper understanding of their experiences.
Research design
Participatory action research (PAR) was employed as the research design for this study. It emphasises the importance of experiential knowledge in addressing issues arising from inequitable and harmful social systems and in conceptualising and executing alternative solutions (Cornish et al. 2023). In this study, PAR facilitated bringing together professionals from diverse educational settings to share their knowledge and experiences in providing academic and therapeutic support for autistic learners. As Puri (2023) observes, PAR focuses on action and emphasises the integration of local priorities and viewpoints directly into the research process. Professionals engaged in collaborative discussions about the challenges under investigation, to facilitate meaningful change. These dialogues were intended to foster a deeper understanding of both the challenges and opportunities in supporting learners with neurodevelopmental conditions. However, a key limitation of the study was the small number of professionals who attended the meeting, which restricted the range of perspectives on the experiences faced by professionals supporting autistic learners.
Participants and procedures
Participants were selected using purposive sampling, focusing on accessibility and relevance to the research. The selection criteria prioritised proximity of schools to the Centre for Neurodiversity, resulting in the inclusion of teachers, assistant teachers, OTs, and parents from four special schools within the Johannesburg Central district. In addition to the centre’s committee members, representatives from key organisations were also invited to contribute. These included representatives from the South African Social Security Agency (SASSA) and the South African Revenue Services (SARS), who provided information on government financial assistance available for children with neurodevelopmental conditions, including autism. A representative from the Department of Education also presented on the ecology of learners with special needs. Throughout the process, ethical considerations were paramount. Participants were fully informed about the purpose of the focus group discussions and provided written consent before participating.
Data collection technique
Focus group discussions are a structured qualitative research method that enables in-depth exploration of topics through guided group interaction (Gundumogula 2020). A 2-h focus group discussion was conducted in English, with participants having the flexibility to express themselves in their local languages when needed. The session was digitally recorded, and participants signed an attendance register that served two purposes: documenting participation and enabling analysis of demographic and gender patterns in caregiving and support for neurodiverse learners across home and school environments. This approach facilitated the collection of rich, multifaceted data from diverse stakeholders. One of the authors moderated the discussion using planned open-ended questions to guide the interaction (Gundumogula 2020). While the discussion generated substantial data, the subsequent transcription and analysis processes proved to be complex and labour-intensive (Mishra 2016).
Data analysis
Thematic analysis, a widely used method in qualitative research, was employed to analyse the rich descriptive data gathered (Naeem et al. 2023). Following established thematic analysis procedures, the video-recorded focus group discussion, which yielded 2 h and 15 min of data, was transcribed verbatim. Three key themes emerged from the analysis: professionals’ experiences supporting autistic learners, parental experiences caring for autistic children, and the complexities surrounding the diagnosis and placement of neurodiverse children. This article focuses specifically on the first theme: professionals’ experiences in supporting autistic learners within feminised educational contexts. The term ‘feminised context’ is used here because all participating professionals and parents were female.
Ethical considerations
Ethical clearance to conduct this study was obtained from the University of Johannesburg, Faculty of Education Research Ethics Committee (ethical clearance no.: Sem 2-2020-055).
Results
Twenty-three participants attended the discussion, representing four special schools. The attendees included 3 teachers, 1 assistant teacher, 2 OTs and 17 parents. As illustrated in Figure 2, all participants were female. The following section presents the findings related to the experiences of these professionals (teachers and OTs) in supporting autistic learners.
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FIGURE 2: Gender representation of the participants. |
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Teachers’ experiences
Teachers and assistant teacher face several challenges in supporting learners with autism in the classroom. Two main challenges during the discussion were identified. Teachers struggled with the behaviour and classroom management and were puzzled by the diagnosis and placement of the children. The following codes were used as identifiers for participants (AT: assistant teacher; OT: occupational therapist; F: female) and a participant number was inserted at the end.
One teacher (T1) explained that there was a challenge with the system of placing learners according to their age in the classroom:
‘… They would investigate the age cohort. They would allocate them depending on their ages … Right and in my class some kids are medium-functioning and low functioning. So, you find challenges that there is a kid with a nappy diaper in a class and a child who is at level 1, a high functioning child. The problem is some of them model behaviour … So I would like to know the best way to develop these kids, how do we allocate them in classes? They regress. Now they are coping behaviours of a child who is low functioning … instead of saying No it’s red, it is colour red, you know, then they pick up the type of behaviour … So, one might copy the other …’ (T1, F, 17)
The assistant teacher (AT1) emphasised the need for specialised training in supporting autistic learners’ behavioural needs. In her own words:
‘We have gained so much knowledge from this discussion, thank you. May you organise a workshop on behaviour management for teachers eyi!’ (AT1, F, 05)
Two teachers raised the issue of diagnosis. They argue that there seems to be misdiagnosing because what is on the primary diagnosis is not what they experience with the learners in day-to-day educational activities. One of them highlighted that:
‘… You find a child with Cerebral palsy, diagnosed with autism … but you see as a teacher, I might be wrong, but this one is more ahh pronounced than autism itself. You feel the child belongs to school X. What determines that this child must be at an Autistic school? They would benefit more when there is physiotherapy you know than in an Autism school … what is on paper is autism … you find that there is more of CP than autism … on a day to day … it does not work … because she is on a chair … she sits there she cannot even relate …’ (T2, F, 14)
She further explained that they reported the case at the district offices, but they were told the child belonged there according to the diagnosis:
‘… because we are not sure that the current support is benefiting her here … we reported to the district, but the district says the diagnosis is saying she belongs in school X.’ (T2, F, 14)
Another teacher shared the same sentiments; however, her case at her school is different in the sense that the child does not have a diagnosis at all:
‘… We have a similar case, but the child does not have a diagnosis. So, the child is in a school of Autism but there is no diagnosis …’ (T3, F, 16)
T2 expressed her puzzlement at how learners are diagnosed:
‘… I have a question but am afraid of saying it … or I do not know how to say it … you see what I have a problem with is how our learners are diagnosed or whether they are severe, or moderate, their behavioural, their intellectual ability … Specifically, the learners with autism, am okay with the rest of the learners but mm … Something is not adding up …’ (T2, F, 14)
Despite all the confusion and challenges in understanding the primary diagnosis, placement and behavioural management when teaching learners with autism, interestingly parents have faith in teachers. One parent argued that teachers must know how to handle these learners.
Occupational therapists’ experiences
Occupational therapists also shared their experiences in supporting teachers, parents and learners with autism. The first issue was related to SASSA requirements for grant applications. The OTs expressed their discontent with the fact that, in most schools, they would spend more time working on SASSA assessments. This burdened an OT who was already under pressure as she would be the only one operating at a school. These are her sentiments:
‘… I have had many parents coming to me and saying the SASSA wants me to draft a report for my child. And I do not know how to draft that report. I understand there is a referral guide or something, but they never bring that to me, I end up referring them back to SASSA, and they still come back with nothing. And they say no SASSA said you must give us the report. Then they now complain about money for transport … and that also strains me because am the only OT there and about 300 learners then mmm … it is a lot …’ (OT, F, 23)
Another OT also highlighted that parents were not supportive of the child’s learning and therapy and there were no efforts by parents to establish good relations with the professionals:
‘… Usually, the last conversation we have between parents, teachers, and therapists is upon admission because the child must be enrolled in school … there is a gap in intervention if you as a parent are not involved in it …’ (OT2, F, 10)
Discussion
The findings of this study reveal significant insights into the gendered nature of care work and support provided to autistic learners in special schools. The striking absence of male participation in both public and private spheres of support is evident from the attendance records, highlighting what Tronto (2013) describes as the ‘default assignment’ of support and care responsibilities to women.
Teachers experience challenges in supporting learners with autism in the classroom. Complexities around diagnosis and placement as well as behavioural management are the main challenges. Kantawala et al. (2023) argue that the diagnosis of autism presents challenges in Africa because of limited familiarity and adaptability with the established tools. It must be observed that most diagnostic tools have a foreign origin. Kantawala et al. (2023) also point to the absence of adequately trained healthcare professionals and insufficient resources as other contributing factors limiting effective diagnosis. The results of the study show that teachers did not understand issues around the diagnosis and placement of autistic learners. Misdiagnosis puts teachers under much stress, as they fail to adequately support the learners. Pillay et al. (2022) also indicate that in the Western Cape, the pathway for supporting learners with autism was an inconsistent and lengthy process. Many children wait for prolonged periods to get access to appropriate school placement. Research findings also indicate that there are cases where a learner is placed in an autistic school, without a supporting diagnosis. Mofokeng et al. (2023) posit that there is a lack of standardised screening and diagnostic tools in South Africa. This is a result of an inconsistent pathway process for diagnosis and placing the learners. These challenges make teachers’ work very difficult and stressful.
Teachers also reported behavioural management challenges in the classroom environment. Classroom environment refers to how the classroom is organised and the atmosphere that prevails, such as placement, sitting arrangements or organisation of the learners in groups. Ouhtit et al. (2014) report that learners with autism display distinct characteristics that vary from mild to severe and may range from nonverbal learners with severe mental retardation and self-injury to highly intellectual learners with above-average IQs, despite social deficits and difficulties in communication. Therefore, teaching such learners can be a demanding task. Research findings indicate that teachers are struggling to manage learners with autism who have been placed in the classroom according to their age cohorts. Such learners have diverse needs. Although teachers use Individualised Education plans to teach the learners, there are some behaviours they tend to copy each other.
Most OTs have situated themselves within various public special schools in South Africa (Sonday et al. 2012). However, the role of OTs in supporting children with autism reveals significant systemic challenges. The study’s findings indicate concerning therapist-to-learner ratios, with one OT potentially supporting up to 300 learners. Research by Ned et al. (2020) indicates a concentration of OTs in private sector settings within economically advantaged provinces, creating a significant service gap in public schools and less resourced areas. This distribution pattern reflects broader healthcare inequities and access barriers in the South African context. Extremely high caseloads significantly impact the quality and frequency of therapeutic interventions. High caseloads also lead to workplace-related stress (De Witt et al. 2024). The OTs’ experiences also highlight administrative burdens, particularly regarding SASSA grant applications, which consume significant professional time that could be devoted to therapeutic interventions. This administrative load, combined with high caseloads, creates a challenging work environment that potentially impacts service quality. The situation is exacerbated by limited parent engagement post-admission, creating what one participant described as a ‘gap in intervention’. Parental participation in child’s educational and therapy support is essential in ensuring proper implementation of intervention plans (Naidoo & Govender 2022). Therefore, limited parental support limits the effectiveness of the OT’s intervention plans and strategies.
The challenges faced by the OTs occur in feminised special education contexts. Thus, the feminisation of care and support work in this context extends to the therapeutic profession, where female OTs predominantly provide these essential services. This gender imbalance in the profession adds another layer to the broader pattern of women’s overrepresentation in caring and supporting learners in special schools. The combination of high caseloads, administrative burdens and limited parental engagement creates a particularly challenging environment for these predominantly female professionals, who must navigate both the technical demands of their role and the emotional labour inherent in care work.
Limitations
A key limitation of this study is its small sample size. The limited number of school-based professionals may not adequately represent the broader demographic and gender composition of professionals supporting learners in special schools, thus constraining the generalisability of the findings.
Recommendation
This study generates various essential recommendations that aim to handle the recognised challenges. The immediate necessity demands gender-responsive frameworks that enhance the representation of diversity in special education roles and therapeutic careers and create extensive training about behavioural management for teachers who teach autistic learners. Systemic development requires assessment of learner-to-therapist ratios and administrative process management and the creation of context-specific diagnostic tools for South African educational settings. Careful programmes for parent involvement combined with professional support networks along with mentor-based programmes should be developed to help professionals handle work-related stress. Research must continue to examine the female–male distribution patterns in special education classes and create assessments and support systems that reflect South African cultural backgrounds. The implementation of more resources demands urgent attention because it directly supports burnout reduction efforts and supplies extra support resources as well as develops professional skills.
Conclusion
This study investigated the experiences of school-based professionals supporting autistic learners in feminised educational settings, revealing significant insights into the challenges and complexities within these contexts. The findings highlight a pronounced gender imbalance in autism support roles, with women predominantly serving as teachers and OTs in special education settings. Teachers face considerable challenges in understanding diagnostic processes, managing classroom behaviours, and supporting learners with varying functional levels within age-based cohorts. Occupational therapists encounter substantial systemic challenges, including overwhelming caseloads of up to 300 learners per therapist, significant administrative burdens related to SASSA grant applications, and limited parental engagement post-admission. The feminisation of these professional roles adds another layer of complexity, as these predominantly female professionals must navigate both the technical demands of their positions and the emotional labour inherent in care and support work. These challenges collectively impact the quality and effectiveness of support provided to autistic learners.
Acknowledgements
The authors would like to thank the Centre Coordinating Committee for their unwavering support. They also acknowledge the role played by Dr Ameen Nausheen in the selection and coordination of the study participants.
Competing interests
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
Authors’ contributions
N.N.N.-C. and M.M.S. organised and conducted the research study. N.N.N.-C. wrote the manuscript. M.M.S. reviewed and edited the article.
Funding information
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Data availability
The authors confirm that the data supporting the findings of this study are available upon request from the corresponding author N.N.N.-C.
Disclaimer
The views and opinions expressed in this article are those of the authors and are the product of professional research. It does not necessarily reflect the official policy or position of any affiliated institution, funder, agency or that of the publisher. The authors are responsible for this article’s results, findings and content.
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